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Concord Hospital Announces No Patients Experienced Falls, with Major Injury, Between May 2013 and May 2014

The Agency for Healthcare Research and Quality (AHRQ) reports between 700,000 and one million hospitalized patients suffer a fall in the U.S. each year. Up to half of those falls cause injury. According to the New Hampshire Health Care Quality Assurance Commission Report, there were 15 falls with major injury among hospitalized patients in New Hampshire in 2012.

Because of alarming figures like those, Concord Hospital’s Board of Trustees set a goal several years ago of having no major injuries as a result of patient falls. Concord Hospital is pleased to announce that from May 2013-May 2014, no patients experienced falls with major injury.

A dedicated Falls Prevention Team made the Concord Hospital environment and care safer by identifying best practices and helping implement them through education and communication. All patients are assessed for risk of falling upon admission. Strategies such as bed alarms that alert caregivers if a patient is trying to get out of bed without assistance, and placing patients in rooms that can be more easily visualized from the clinical work station are put in place for those patients at higher risk. In addition, the team initiated several innovative practices on all inpatient units aimed at improving communication with patients, which can reduce or eliminate falls that result in major injury (prolonged hospitalization, unplanned surgery, additional treatment, permanent injury or death).

Efforts included:

Purposeful Rounding - Nurses and Licensed Nursing Assistants visit each patient hourly, except at night, when sleep is important. During hourly rounds, nurses attend to a patient’s pain, positioning and safety concerns, which can lessen a patient’s anxiety and reduce the risk of falling.

Standardized Communication Boards - All patient rooms now include Patient Communication Boards designed to provide patients, family members and care providers a uniform, easy-to-read source for each patient’s daily plan of care and safety concerns, such as falls risk.

Leadership Rounding - Nursing leadership meets with patients to learn about the care being provided, challenges patients face while hospitalized and to solicit input on what could be improved, in an effort to consistently exceed each patient’s expectations.

Bedside Shift Report - At staff shift changes, outgoing and oncoming nurses exchange important information about the care of the patient with each other at the bedside so the patient can be included in the discussion and meet their oncoming nurse.

Post Falls Debriefings - Following each patient fall, a team of leadership, staff and the patient meet to discuss the reason for the fall, patient risk factors and strategies that could have been utilized to keep the patient safe.

The five innovations not only contributed to eliminating patient falls with major injury, but improved the Hospital’s Hospital Consumer Assessment of Healthcare Providers and Systems (HCAPS) scores for “Communication with Nurses,” raising Concord Hospital to the 92 percentile nationally. Concord Hospital continues to explore other innovations that might help improve and sustain our efforts to keep patients safe.